Oral inflammation and pain, also called stomatitis, is a common, debilitating complication of cancer chemotherapy and radiotherapy, occurring in about 40% of patients. It results from the systemic effects of cytotoxic chemotherapy agents and from the local effects of radiation to the oral mucosa. Oral inflammation and pain is inflammation of the mucosa of the mouth which ranges from redness to severe ulceration.
Symptoms of inflammation and pain vary from pain and discomfort to an inability to tolerate food or fluids. Inflammation and pain may also limit the patient's ability to tolerate either chemotherapy or radiotherapy. Inflammation and pain may be so severe as to delay treatment and so limit the effectiveness of cancer therapy. Patients with damaged oral mucosa and reduced immunity resulting from chemotherapy and radiotherapy are also prone to opportunistic infections in the mouth. The inflammation and pain may affect patients' gum and dental condition, speech and self esteem are reduced, further compromising patients' response to treatment and/or palliative care. It is therefore extremely important that inflammation and pain be prevented.
Pain, oral dysfunction, and gastrointestinal distress are commonly experienced by patients with mucositis, independent of the grade or severity. The rapid rate of mitosis in mucosal tissue makes it highly prone to injury from both chemotherapy and radiation. Mucositis can affect nutritional status, speech, comfort, and treatment compliance. The pain from oral mucositis has been reported as the most distressing symptom by patients receiving treatment for head and neck cancer, and chemotherapy.
Some studies have also reported a distribution of these lesions on keratinized surfaces such as the hard palate and upper surface of the tongue. If ulcerations are noted in these areas, cultures and/or biopsies should be taken from the lesions to rule out viral infections or other causes. Redness and/or ulcerations, ranging from a few millimeters to a few centimeters long, can appear. Bleeding from the ulcerations is common; however, bleeding often reflects a severe reduction in a patient's platelet count, a condition called thrombocytopenia.
Until novel therapies are shown to be effective, multiple, evidenced-based, interventional approaches are needed to decrease the emotional and physical distress caused by acute oral pain and mucositis.
Managing acute pathology of often relies on the addressing underlying pathology and symptoms of the disease. There is currently a need in the art for new compositions to treatment or delay of the onset of inflammation and pain and its associated complications progression.